National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Cancer (2)
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- Children/Adolescents (1)
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- (-) Diagnostic Safety and Quality (15)
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- (-) Health Information Technology (HIT) (15)
- Heart Disease and Health (1)
- Imaging (6)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Kidney Disease and Health (1)
- Medical Errors (1)
- Patient Safety (4)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Quality Improvement (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 15 of 15 Research Studies DisplayedAneja S, Chang E, Omuro A
Applications of artificial intelligence in neuro-oncology.
This article explores the promise that artificial intelligence algorithms has for improving understanding of brain tumors and help drive future innovations in neuro-oncology.
AHRQ-funded; HS023000.
Citation: Aneja S, Chang E, Omuro A .
Applications of artificial intelligence in neuro-oncology.
Curr Opin Neurol 2019 Dec;32(6):850-56. doi: 10.1097/wco.0000000000000761.
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Keywords: Health Information Technology (HIT), Cancer, Diagnostic Safety and Quality, Imaging
Campione JR, Mardon RE, McDonald KM
Patient safety culture, health information technology implementation, and medical office problems that could lead to diagnostic error.
Researchers investigated the relationship between patient safety culture, health information technology (IT) implementation, and the frequency of problems that could lead to diagnostic errors in the medical office setting. Using survey data from the 2012 Agency for Healthcare Research and Quality Medical Office Surveys on Patient Safety Culture database, they found that the most frequent problem was "results from a lab or imaging test were not available when needed," with 15% of respondents reporting that it happened daily or weekly. Higher overall culture scores were significantly associated with fewer occurrences of each problem assessed, and offices in the process of health IT implementation had higher frequency of problems.
AHRQ-funded; 290201200003I.
Citation: Campione JR, Mardon RE, McDonald KM .
Patient safety culture, health information technology implementation, and medical office problems that could lead to diagnostic error.
J Patient Saf 2019 Dec;15(4):267-73. doi: 10.1097/pts.0000000000000531..
Keywords: Surveys on Patient Safety Culture, Health Information Technology (HIT), Diagnostic Safety and Quality, Patient Safety, Ambulatory Care and Surgery
Lacson R, Gujrathi I, Healey M
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
This study looked at the impact of implementing a tool called SCORE (System for Coordinating Orders for Radiology Exams), whose objective is to manage unscheduled orders for outpatient diagnostic imaging in an electronic health record (EHR) with embedded computerized physician order entry. The rate of unscheduled imaging orders was compared before SCORE (October 2017 to September 2018) and after (October 2018 to June 2019). There was a 49% reduction in unscheduled orders after SCORE implementation at a large academic institution.
AHRQ-funded; HS024722.
Citation: Lacson R, Gujrathi I, Healey M .
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
J Am Coll Radiol 2021 Jan;18(1 Pt A):60-67. doi: 10.1016/j.jacr.2020.09.031..
Keywords: Imaging, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Levy AE, Shah NR, Matheny ME
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
The authors investigated whether Natural Language Processing (NLP) tools could potentially help estimate myocardial perfusion imaging (MPI) risk. Subjects were VA patients who underwent stress MPI and coronary angiography 2009-11; stress test reports were randomly selected for analysis. The authors found that post-test ischemic risk was determinable but rarely reported in this sample of stress MPI reports. They conclude that this supports the potential use of NLP to help clarify risk and recommend further study of NLP in this context.
AHRQ-funded; HS022998.
Citation: Levy AE, Shah NR, Matheny ME .
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
J Nucl Cardiol 2019 Dec;26(6):1878-85. doi: 10.1007/s12350-018-1275-y..
Keywords: Imaging, Risk, Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Cardiovascular Conditions, Heart Disease and Health
Danforth KN, Hahn EE, Slezak JM
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
This study examined the rates of follow-up with patients after abnormal estimated glomular filtration rate (eGFR) laboratory results, which may indicate chronic kidney disease. A large integrated health system was used with a total of 244,540 patients aged 21 or older with abnormal eGFRs were included from January 2010 through December 2015. Timely follow-up was defined as repeat eGFR testing within 60 to 150 days, follow-up testing before 60 days that indicated normal kidney function, or diagnosis before 60 days of chronic kidney disease or kidney cancer. Follow-up was found to be poor, with 58% of patients lacking timely follow-up. Fifteen physicians were also interviewed and it was found that both system-level and provider-level factors influenced follow-up rates.
AHRQ-funded; HS024437.
Citation: Danforth KN, Hahn EE, Slezak JM .
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
Am J Kidney Dis 2019 Nov;74(5):589-600. doi: 10.1053/j.ajkd.2019.05.003..
Keywords: Healthcare Delivery, Diagnostic Safety and Quality, Kidney Disease and Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Kang SK, Garry K, Chung R
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
The authors developed natural language processing (NLP) to identify incidental lung nodules (ILNs) in radiology reports for assessment of management recommendations using the electronic health records for patients who underwent chest CT before and after implementation of a department-wide dictation macro of the Fleischner Society recommendations. They concluded that NLP reliably automates identification of ILNs in unstructured reports, pertinent to quality improvement efforts for ILN management.
AHRQ-funded; HS024376.
Citation: Kang SK, Garry K, Chung R .
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
J Am Coll Radiol 2019 Nov;16(11):1587-94. doi: 10.1016/j.jacr.2019.04.026..
Keywords: Imaging, Diagnostic Safety and Quality, Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Quality of Care
Quinn M, Forman J, Harrod M
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis requires that clinicians communicate and share patient information in an efficient manner. Advances in electronic health records (EHRs) and health information technologies have created challenges and opportunities for such communication. In this multi-method, focused ethnographic study of physicians on general medicine inpatient units in two teaching hospitals, the investigators found that existing communication technologies and EHR-based data sharing processes were perceived as barriers to diagnosis. In particular, reliance on paging systems and lack of face-to-face communication among clinicians created obstacles to sustained thinking and discussion of diagnostic decision-making.
AHRQ-funded; HS022835; HS024385.
Citation: Quinn M, Forman J, Harrod M .
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis 2019 Aug 27;6(3):241-48. doi: 10.1515/dx-2018-0036.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality, Communication
Deng F, Li MD, Wong A
Quality of documentation of contrast agent allergies in electronic health records.
The purpose of this study was to describe and appraise contrast agent allergy documentation in the electronic health record (EHR). The investigators concluded that contrast allergy records in EHRs were diverse and commonly low quality. They suggest that continued EHR enhancements and training are needed to support contrast allergy documentation to facilitate improved patient care and medical research.
AHRQ-funded; HS025375.
Citation: Deng F, Li MD, Wong A .
Quality of documentation of contrast agent allergies in electronic health records.
J Am Coll Radiol 2019 Aug;16(8):1027-35. doi: 10.1016/j.jacr.2019.01.027..
Keywords: Adverse Drug Events (ADE), Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging
Sorkin DH, Rizzo S, Biegler K
AHRQ Author: Ngo-Metzger Q
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
This article describes a multicomponent health information technology screening tool designed to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder (PTSD) in the primary care setting, with an eye toward meeting the mental health needs of traumatized refugees in the US Cambodian community. In a randomized controlled trial, 18 primary care providers were randomized to receive access to the mental health screening intervention, or to a minimal intervention control group. Cambodian American patients empaneled to participating providers were assigned to the providers' randomized group. From the results, the authors conclude that this approach offers the potential for training providers to diagnose and treat traumatized patients seeking mental health care in primary care.
AHRQ-authored.
Citation: Sorkin DH, Rizzo S, Biegler K .
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S190-s96. doi: 10.1097/mlr.0000000000001036..
Keywords: Depression, Diagnostic Safety and Quality, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Racial and Ethnic Minorities, Screening
Murphy DR, Meyer AN, Sittig DF
Application of electronic trigger tools to identify targets for improving diagnostic safety.
This article discusses the use of electronic trigger tools to reduce diagnostic errors and improve patient safety. The authors present a framework called Safer Dx Trigger Tools Framework that will enable health systems to develop and implement e-trigger tools. It identifies and measures diagnostic errors using comprehensive electronic health record (EHR) data. The application of the algorithms used will require a diverse team of specialists to implement. Future research is also outlined.
AHRQ-funded; HS022901; HS022087; HS017820.
Citation: Murphy DR, Meyer AN, Sittig DF .
Application of electronic trigger tools to identify targets for improving diagnostic safety.
BMJ Qual Saf 2019 Feb;28(2):151-59. doi: 10.1136/bmjqs-2018-008086..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Singh H, Zwaan L
Annals for hospitalists inpatient notes - Reducing diagnostic error-a new horizon of opportunities for hospital medicine.
The authors argue that given the importance of diagnoses in the hospital, hospitalists are well-positioned to lead efforts to promote correct and timely diagnosis. However, to reduce harms from diagnostic errors, hospitalists must first understand how these errors occur and then develop practical strategies to avoid them.
AHRQ-funded; HS022087; HS023602.
Citation: Singh H, Zwaan L .
Annals for hospitalists inpatient notes - Reducing diagnostic error-a new horizon of opportunities for hospital medicine.
Ann Intern Med 2016 Oct 18;165(8):HO2-HO4. doi: 10.7326/m16-2042.
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Keywords: Medical Errors, Diagnostic Safety and Quality, Patient Safety, Health Information Technology (HIT), Inpatient Care
Murphy DR, Meyer AN, Bhise V
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
A "trigger" algorithm was used to identify delays in follow-up of abnormal chest imaging results in a large national clinical data warehouse of electronic health record (EHR) data. In this study, the authors applied a trigger in a repository hosting EHR data from all Department of Veterans Affairs health-care facilities and analyzed data from seven facilities. The investigators concluded that application of triggers on "big" EHR data may aid in identifying patients experiencing delays in diagnostic evaluation of chest imaging results suspicious for malignancy.
Citation: Murphy DR, Meyer AN, Bhise V .
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
Chest 2016 Sep;150(3):613-20. doi: 10.1016/j.chest.2016.05.001..
Keywords: Imaging, Electronic Health Records (EHRs), Health Information Technology (HIT), Data, Diagnostic Safety and Quality, Cancer
Wiseman JT, Fernandes-Taylor S, Gunter R
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
The authors evaluated whether smartphone digital images can supplant in-person evaluation of postoperative vascular surgery wounds. They concluded that using smartphone digital images is a valid method for evaluating postoperative vascular surgery wounds and is comparable to in-person evaluation with regard to most wound characteristics. The inter-rater reliability for determining treatment recommendations was universally high.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Gunter R .
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
J Vasc Surg Venous Lymphat Disord 2016 Jul;4(3):320-28.e2. doi: 10.1016/j.jvsv.2016.02.001.
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Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Telehealth, Surgery, Health Information Technology (HIT), Diagnostic Safety and Quality
Goldberg EM, Levy PD
New approaches to evaluating and monitoring blood pressure.
The authors reviewed the current literature on mobile health technologies and novel diagnostic and management protocols and made recommendations on how to incorporate these innovations into practice. They recommend collaboration between device designers and clinical researchers to develop rigorous clinical trials to test cardiovascular outcomes associated with emerging technologies.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Levy PD .
New approaches to evaluating and monitoring blood pressure.
Curr Hypertens Rep 2016 Jun;18(6):49. doi: 10.1007/s11906-016-0650-9.
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Keywords: Blood Pressure, Telehealth, Health Information Technology (HIT), Diagnostic Safety and Quality
Lawrence JM, Black MH, Zhang JL
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
The researchers explored the utility of different algorithms for diabetes case identification by using electronic health records. They found that case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications.
AHRQ-funded; HS019859.
Citation: Lawrence JM, Black MH, Zhang JL .
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
Am J Epidemiol 2014 Jan;179(1):27-38. doi: 10.1093/aje/kwt230..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality